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Postpartum Polyarthragia? In a lot of Pain - Ankles, Feet, Hands, Wrists, Spine - Is This a Flare?

Hello. I was diagnosed in 1991 with Crohn's disease at 10 years old. I have been in remission and not taking any prescriptions since 2001. I got pregnant last August 2014 and gave birth this year in May. Nearing the end of my second trimester I developed what my OB called, pregnancy induced carpal tunnel syndrome. At the same time, I was also diagnosed with hypothyroidism. At the end of my pregnancy I also developed hypertension and had to be induced a few days before my due date. I was immediately taken off the thyroid medication right after delivery.

The first two months my hands and wrists got progressively worse and I was referred to a hand orthopedist. The orthopedist agreed with my OB that it was hormone related and that it should clear up soon. It didn't. In fact, just before I saw the orthopedist, I started to get very similar pains in my feet and ankles that was also accompanied by burning and numbness. My thyroid was tested two weeks after delivery with "normal" results and again at 12 weeks with "normal" results.

During all this time I had the regular tiredness you would feel from waking up several times during the night to nurse (I am breastfeeding). When my ankle/foot pain started to progress, I noticed I was getting severe fatigue. My baby was at the time and still is, only waking 1-2 times during the night to feed and I am now able to get 7-9 hours of sleep altogether. I am more exhausted now than I was in the first two months. It has been 19 weeks since I gave birth now.

I have had x-rays done of my wrists hands, ankles, feet and spine. None of which explain my pains. My hand/wrist, and foot/ankle x-rays were normal with only mild osteoarthritis found in my right hand. I do have scoliosis with a 19% and 9% S-shaped curvature with kyphosis in my thoracic spine. My pains and weakness is getting worse and I am only able to take acetaminophen since I am nursing.

My primary care physician has diagnosed me with polyarthralgia and is unsure what may be the true cause of my condition. I have been referred to several different types of doctors including: neurologist, rheumatologist, pain management, physical therapy, spinal orthopedist, and endocrinologist. The endocrinologist ordered labs recently to check my thyroid, B12 and male hormone levels. I have not gotten those results yet. He thought my symptoms may also be related to my Crohn's disease. I am having a nerve conduction study and an MRI done soon. The rheumatologist said he didn't think I had a rheumatological condition and sent me away. I am waiting for a referral to see a gastroenterologist in my area. I saw the hand orthopedist one last time and he said it was a good idea to go to an endocrinologist since he was unable to truly diagnose or treat me entirely (he only does hands).

My conditions have progressed both in my hands/wrists and feet/ankles. I am experiencing: Constant aching, sharp shooting pains, stabbing pains, electric shock, numbness, burning, weakness and losing mobility in my left foot. Hot and cold compresses make the feelings worse. The pains are also worse at night and may be a cause of my fatigue during the day. I am seeking to find if anyone else has had a similar experience after pregnancy so that I may be able to find the root cause, treat my symptoms and get some relief finally. I have not been able to return to work because of my conditions and I have problems caring for my infant sometimes because I am too weak or in too much pain to pick him up and hold him. I have had to take to laying down most of the time in order to feed him. I know now that Crohn's disease being an autoimmune disorder, can attack other parts of the body, especially the joints. I'm not sure why I was not referred to a gastroenterologist in the first place based on my medical history with Crohn's disease.

Any thoughts or ideas regarding what may be causing my symptoms are welcome! Thank you!!!
 
Hello,

I also have a 19 nearly 20 week daughter and since giving birth have had problems with my joints but I have had this before so knew that it was arthritis related to crohn's. I was hospitalised at the end of August because of the pain and swelling along with gut symptoms. I am no longer breastfeeding but I was told that I would be able to have steroids if I was and they help really quickly to get the pain under control. Is it possible to see another rheumatologist? If not your GI should know more about it, I don't know if it's the same anywhere else but my GI department has a joint clinic once a month which is really helpful.
I have tingling in my back and shoulder blades but I had a spinal as I had a csection but haven't asked my dr about this yet it's on my list of things to sort out.
I really hope you can find out what's going on soon it's hard enough looking after a little one without having to worry about your health and if you can manage in the day x
 
Hello,

I also have a 19 nearly 20 week daughter and since giving birth have had problems with my joints but I have had this before so knew that it was arthritis related to crohn's. I was hospitalised at the end of August because of the pain and swelling along with gut symptoms. I am no longer breastfeeding but I was told that I would be able to have steroids if I was and they help really quickly to get the pain under control. Is it possible to see another rheumatologist? If not your GI should know more about it, I don't know if it's the same anywhere else but my GI department has a joint clinic once a month which is really helpful.
I have tingling in my back and shoulder blades but I had a spinal as I had a csection but haven't asked my dr about this yet it's on my list of things to sort out.
I really hope you can find out what's going on soon it's hard enough looking after a little one without having to worry about your health and if you can manage in the day x
Thank you so much for your reply! I'm glad to hear that I'm not alone. Being a new mother is hard in itself, and being in pain with no help in sight has been really disheartening. I plan to see a GI as soon as I can get an appointment. As for seeing another rheumatologist, I will wait for my hormone test results and go from there. I did feel as if he brushed me off because he couldn't figure out what was causing my symptoms. I'll post an update soon, since I will have my test results later in the week and am taking a nerve conduction test tomorrow. I did have an episode today them at freaked me out though. My right arm basically went half limp for a little while. It works now, but I'm afraid it will happen again, possibly to another limb in a more precarious situation.
 
Definitely not alone :) it really is tough. Oh no that does sound scary, I hope your tests go well today and they can give you some answers.
 
Definitely not alone :) it really is tough. Oh no that does sound scary, I hope your tests go well today and they can give you some answers.
So I saw the neurologist today and we went over my EMG and MRI results. The MRI was normal. Well it obviously showed my scoliosis and moderate kyphosis. There wasn't anything else that stood out though. The EMG however showed abnormalities with my peroneal nerve associated with the S1 vertebrate. So this explained my numbness and lack of mobility in my foot. But it still doesn't explain what is causing the issue with my nerve, or anything else for that matter. The neurologist basically said I should talk to my spinal orthopedist more in depth about the results of the EMG and MRI. I have my appointment with the spinal orthopedist in mid-November. In the mean time, I've been getting more sciatica in the past week along with abdominal pain and tenderness and loose stools. So a Crohns flare up is sounding more imminent as the explanation for some of my issues at least. I saw my primary care physician last week and got my referral to see the gastroenterologist. Hopefully I will be able to schedule with them soon. I'm feeling now like I've done all of this testing and seen all these specialists for nothing. I'm in a perpetual waiting game for answers and pain relief. It's really starting to get to me.
 
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